The WHO Alcohol Misure Early Treatment Intervention Study (AMETHYST PROJECT) is a multinational field trial of low cost intervention strategies suitable for use with early problem drinkers in the primary health care setting. This application describes the role of the University of Connecticut Alcohol Research Center in a collaborative study to be coordinated by the WHO Division of Mental Health and conducted independently in Wales, Costa Rica, Australia, Norway, Mexico, Kenya, Bulgaria and the United States. The specific aims of the project are (1) to study the relative contributions of simple advice, brief counseling and periodic monitoring to changes in drinking behavior six months and one year after the initial intervention, (2) to investigate the mediating role of reduced consumption on the incidence of alcohol-related problems, and (3) to evaluate the robustness and cross-national generalizability of early intervention strategies at hospital-based performance sites in two countries. In the U.S. and Mexican components (for which funds are requested in this application), 240 non-alcoholic, nondependent drinkers considered to be consuming alcohol in a potentially harmful way will be randomly assigned to one of six conditions representing three levels of intervention (control, simple advice, brief counseling) and two levels of monitoring (no monitoring, periodic monitoring). The simple advice condition will consist of firm encouragement to reduce the quantity and frequency of alcohol consumption to less than 40g ethanol per day. The brief counseling session will consist of information feedback, individual goal setting, and a review of behavioral change strategies. The latter will be guided by a self-help manual which the subject will be encouraged to use with the assistance of a spouse, family member or close friend. periodic monitoring will consist of return visits to the counselor who will review the subject's drinking behavior, provide simple advice, and take a blood sample. Outcome measures including quantity and frequency of drinking, changes in social adjustment and alcohol related problems, and variations in biochemical measures (MCV, GGTP) will be assessed six months and one year after the initial intervention.